310 Exam 2 Study Guide

Which is the concentration of estradiol in the blood during the follicular phase of the menstrual cycle?

130 pg/mL

Which test helps identify reproductive tract fibroids, tumors, and fistulas?

Hysterosalpingography (Explanation: x-ray used to evaluate tubal anatomy and patency and is further used to identify uterine problems such as fibroids, tumors, and fistulas)

Which client statement indicates understanding of content taught about removing his or her three-way indwelling catheter and continuous bladder irrigation (CBI)?

I probably will experience some burning on urination

Which explanation will the nurse give when a client asks about what causes varicose veins?

Incompetent valves of superficial veins

How would anxiety affect outcomes for a client with heart failure?

Increases the cardiac workload

Which assessment is necessary for the nurse to complete in a client with chronic kidney disease receiving loop diuretics?

Intake and output measurement

Which part of the kidney produces the hormone bradykinin?

Juxtaglomerular cells of the arterioles

Which finding in a urinalysis indicates a urinary tract infection?

Leukoesterase

A pathology report states a client's urinary calculus is composed of uric acid. Which food item would the nurse instruct the client to avoid?

Liver

Which hormone is crucial for ovulation and complete maturation of the ovarian follicles?

Luteinizing hormone

A 55-year-old client reports cessation of menstrual periods for a year. Which term describes the client's condition?

Menopause

Which term would the nurse document in the client's medical record after observing reduced urinary output?

Oliguria (Explanation: A reduced urinary output of less than 400 mL in a 24-hour interval is called oliguria. Anuria is the absence of urination. Painful or difficult urination is called dysuria. Frequent urination at night is called nocturia.)

How would the nurse document a drop in blood pressure when a client moves rapidly from a lying to a standing position?

Orthostatic hypotension

Which physical assessment maneuver is the nurse performing when placing the nurse's left hand under on the client's right lower back between the rib cage and the iliac crest?

Palpation

Which substance is released in response to low serum levels of calcium?

Parathyroid hormone

Which term is used to describe a client passing air and bubbles during urination?

Pneumaturia (could be the result of fistula formation)

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis report. Which urinary finding indicates the need to notify the primary health care provider?

Presence of large proteins (Explanation: The glomeruli are not permeable to large proteins such as albumin or red blood cells, and finding them in the urine is abnormal)

The client with a suprapubic prostatectomy for cancer of the prostate has continuous bladder irrigations (CBI) in place after surgery. Which primary goal is the nurse trying to achieve with the CBI?

Prevent the development of clots in the bladder.

Which structure surrounding the male urethra would the nurse describe to a client scheduled for a dilation of the urethra?

Prostate gland

Based on an electrocardiogram (ECG), a client is suspected to have hypokalemia. Which test will be used to confirm hypokalemia?

Serum potassium level

Which instruction would the nurse include in a health practices teaching plan for a female client with a history of recurrent urinary tract infections?

Wear cotton underwear or lingerie

How is hemophilia A inherited?

X-linked recessive trait (daughters who have the gene are carriers, and sons with the gene have the condition)

What is the term for ischemic pain of peripheral arterial disease?

intermittent claudication

What are the complications of PAD that often lead to amputation?

non-healing ischemic ulcers and gangrene

Which intervention would the nurse perform when caring for a client in the emergency department reporting chest pain? Select all that apply. One, some, or all responses may be correct.

oxygen, vital signs, 12-lead ECG, blood work for cardiac enzymes, auscultating heart sounds, nitroglycerin

What are the 6 P's of acute arterial occlusion?

pain, pallor, polar(cold), paralysis, paresthesia, pulselessness

What are some treatments for peripheral arterial disorders?

sympathectomy, bypass graft, thrombectomy

Which electrical activity of the cardiac conduction system is reflected in the QRS complex?

ventricular depolarization (atrial repolarization also occurs simultaneously)

Which electrical activity of the cardiac conduction system is reflected in the T wave?

ventricular repolarization

After the nurse has finished teaching a client about sickle cell anemia, which statement indicates that the client has a correct understanding of the condition?

"I have abnormal hemoglobin."

Normal PR interval time

0.12 to 0.20 seconds

What are the three most immediate treatments in order of importance for urinary calculi?

1. Relieve pain (Opioids, antispasmodic agents, NSAIDs) 2. Hydration (3-4 L per day) 3. Strain urine to monitor passing of stone

Which urine specific gravity level is abnormal? a) 1.006 b) 1.012 c) 1.028 d) 1.041

1.041

During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)?

2 min

When performing cardiac compression on an adult client, how far would the nurse depress the lower sternum?

2 to 2.4 inches (5-6 cm)

Normal potassium range

3.5-5.0 mEq/L

The nurse recalls that, according to the AHA guidelines for adult CPR, the correct compression: ventilation ratio and rate per minute is which of the following?

30:2, at least 100/min

During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. If administering Vasopressin, what dosage would the nurse expect to administer?

40 Units IV/IO

Which of these clients seen at a health fair will be most at risk for hypertension?

62-year-old African American man

After measuring a client's PR interval at 0.08 seconds, how would the nurse interpret the finding?

Abnormally fast conduction

What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation?

Amiodarone (Explanation: As per the AHA guidelines, the medication to give to the patient after continuing CPR and administering the epinephrine is amiodarone 300 mg with a second dose of amiodarone 150 mg, if needed.)

When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority?

Assessing the carotid pulse

What are common teachings for patients to prevent urinary calculi?

Avoid protein intake Reduce sodium intake Keep calcium within normal limits Avoid foods with high oxalate (Spinach, Strawberries, Tea, Peanuts) Drink adequate water every 1-2 hours

Which of the following are cardiac markers assessed in the patient experiencing angina to determine potential myocardial injury? (Select all that apply.)

CK-MB, Troponin

When a client who is taking a diuretic has been instructed to eat foods high in potassium, which fruit would the nurse suggest?

Cantaloupe

Which disorder is a primary glomerular disease?

Chronic glomerulonephritis

The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? (Select all that apply.)

Cigarette smoking, Family history, Metabolic syndrome

When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? (Select all that apply.)

Clearing the bed at least twice prior to defibrillating, Not touching the bed or allowing any objects to touch the bed, Removing the oxygen from the bed during defibrillation

When assessing a client with heart failure for activity tolerance, which activity would the nurse expect to cause the most distress for the client?

Climbing a flight of stairs to the bedroom

Which urine characteristic is consistent with a urinary tract infection?

Cloudy

Which finding during peritoneal dialysis would the nurse act on as a sign of infection?

Cloudy return of dialysate

What are the MOST indicative signs of urinary calculi?

Colicky/spastic pain in the flank area N/V Urinary urgency or frequency Hematuria

Which component of the client's nephron acts as a receptor site for the antidiuretic hormone to regulate water balance?

Collecting ducts (Explanation: The collecting ducts regulate water balance and act as a receptor site for antidiuretic hormone)

Why is avoiding contrast in imaging of a urinary calculi essential?

Contrast is excreted by the kidneys, therefore you want to decrease overall kidney workload

Which food selection indicates understanding of sources with high biologic value protein?

Cottage cheese

A client arrives at a health clinic reporting a recent onset of hematuria, frequency, urgency, and pain on urination. Which diagnosis will the nurse observe in the client's medical record?

Cystitis

Which test provides information on bladder capacity, bladder pressure, and voiding reflexes?

Cystometrography (CMG)

When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? (Select all that apply.)

Decreases pain, Decreases afterload, Decreases anxiety, Decreases preload

Which conclusion would the nurse make about the assessment finding of a client's very pale-yellow-colored urine?

Dilute urine

Which report by the client post transrectal prostate biopsy needs to be communicated to the health care provider as a possible sign of infection?

Discharge from the penis

Which action would the nurse take to prevent venous thrombus formation after abdominal surgery?

Encourage the client to ambulate multiple times daily

When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency?

Every 5 minutes, maximum 3 doses

Is the following statement TRUE or FALSE? If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention.

FALSE (Explanation: AHA guidelines do not support defibrillation for asystole.)

What are other clinical manifestations of urinary calculi?

Fever and chills Obstruction of urinary flow from the kidneys Tissue trauma (May lead to renal injury or failure) Infection

What problems can arise from an unhealthy kidney?

Fluid overload Elevated labs (Urea, Creatinine, Potassium) Changes in hormone levels that control blood pressure, making of RBCs, uptake of calcium

How are urinary calculi diagnosed?

History Physical assessment Urinalysis (Hematuria, S/S of infection, Crystals pH) Imaging for location and size

What are risk factors of BPH?

Increasing age Race/ethnicity Genetics Prostatic enlargement Lower urinary tract symptoms Decreased urinary flow rate Elevated PSA

When arterial blood gases done on a client who is being resuscitated after cardiac arrest show a low pH, which factor is the likely cause of the laboratory result?

Lactic acid production

Which part of the kidney senses changes in blood pressure?

Macula densa

What is the main purpose of the urinary system?

Maintain the body's homeostasis by regulating fluid and electrolytes and removing waste

What test would be done in a patient with chronic urolithiasis and what does the test include?

Metabolic workup (serum calcium, phosphorus, uric acid) 24 hour urine Urine culture (If all above are normal, 24 hour urine for citrate and urine oxalate)

What are the important steps of caring for a patient with urolithiasis?

Monitor I+O Manage pain Continue antibiotic therapy as prescribed Diet modifications to reduce protein and calcium Encourage clear fluid intake Patient teaching

What imaging would be used to determine an urinary calculi?

Non-contrast CT is best (Ultrasound if pt cannot have radiation)

What is benign prostatic hyperplasia? and what can it lead to?

Nonmalignant enlargement of the prostate gland

Which term is used for the tip of a pyramid in the kidney?

Papilla

Which phase of a woman's sexual response is characterized by elevation of the uterus?

Plateau phase

What are the functions of a healthy kidney?

Removal of sodium and water Removal of waste Hormone production

What are the top three goals of treatment for urinary calculi?

Remove the stone Figure out what type of stone it is Prevent damage to nephrons, kidneys, etc and relieve obstruction

In what order does normal cardiac conduction occur through the heart?

SA node, AV node, Bundle of His, Bundle branches, Purkinje fibers

What are possible risk factors of developing urinary calculi or urolithiasis?

Sedentary lifestyle/prolonged immobility Male gender Obesity Family history Personal history (50% reoccurrence) Dietary factors Other conditions

Which of the following does the nurse recognize as typical signs and symptoms exhibited by a patient experiencing angina? (Select all that apply.)

Shortness of breath, Diaphoresis, Substernal chest pain

A client diagnosed with invasive cancer of the bladder has brachytherapy scheduled. Which successful therapy outcome would the nurse expect with this client?

Shrinkage of the tumor when scanned

What is the function of the prostate?

Store and secrete a clear, alkaline fluid that constitutes part of seminal fluid

Which action will the nurse take to determine a client's pulse pressure?

Subtract the diastolic from the systolic reading

What is the typical patient presentation of urinary calculi?

Sudden, severe, one sided, colicky pain Radiates to the groin Nausea Few episodes of vomiting Hematuria (Due to internal damage from the stone) Guarding of the flank area Decreased appetite Increased temp, BP (due to severe pain)

What other treatments are important for urinary calculi?

Symptom management Prevention of stone recurrence Dietary modifications Shockwave lithotripsy (Only used for stones less than 2 cm) Other procedures (Ureteroscopy, Percutaneous lithotomy, Percutaneous nephrostomy) Surgery if all else fails

Is the following statement TRUE or FALSE? According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation.

TRUE (Explanation: As per the guidelines, epinephrine can be administered every 3 to 5 minutes. The first dose of epinephrine is administered after the second defibrillation.)

What is urolithiasis?

The process of forming stones in the kidney, bladder, and/or urethra

The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons?

To prevent platelet aggregation

When a client with angina is scheduled to have a cardiac catheterization, which explanation would the nurse give about the purpose of the procedure?

To visualize the disease process in the coronary arteries

What are predisposing factors that may lead to stone formation and why?

UTI Urinary stasis Prolonged immobility Impacted calcium metabolism Allow the slowing down/stasis of renal drainage

What are possible causes of urinary calculi?

Urinary stasis Supersaturation of urine with poorly soluble crystalloids Increased concentration of metabolic products, leading to increased calcium, uric acid, and phosphate Changes in urine pH Deficiency of stone-forming inhibitors such as citrate, pyrophosphate, and magnesium Infection Foreign bodies Failure to completely empty bladder

Which action would the nurse take after having difficulty in palpating the pedal pulse of a client with venous insufficiency?

Verify the pulse by using a Doppler

When teaching a client with atrial fibrillation about a new prescription for warfarin, the nurse will include information about which vitamin?

Vitamin K

What two main categories encompass the type of symptoms that may be caused by BPH?

Voiding (obstructive) or storage (irritative/filling)

Which hormone influences kidney function?

aldosterone

The amount of work done by the pancreas is regulated by what hormone?

androgen

Indicate whether the following findings are manifestations of arterial (A) or venous (V) disease: -Paresthesia -Gangrene over bony prominences on toes and feet -Decreased peripheral pulses - Thickened, brittle nails -Pallor on elevation of legs -Flushed skin when legs are dependent

arterial disease

What does ventricular fibrillation look like?

bizarre unidentifiable waves on EKG

Which collecting structure is located at the end of the renal papilla?

calyx (Explanation: The calyx is a cuplike structure that collects urine and is located at the end of each papilla)

What causes benign prostatic hyperplasia?

cellular hyperplasia from androgens leading to growth

A distended bladder will sound ________ on percussion.

dull

Which laboratory value would the nurse assess when preparing a client for a renal biopsy? Select all that apply. One, some, or all responses may be correct.

hematocrit, hemoglobin, platelet count, PT with INR (prothrombin time with international normalized ratio), PTT (partial thromboplastin time)

A serum potassium level less than 3.5 mEq/L indicates:

hypokalemia

What physiological process is suspected when the T wave on an ECG tracing is depressed or flattened?

hypokalemia

A client just had a total hip replacement and is experiencing restlessness and changes in mentation. Which complication would the nurse consider the client may be experiencing based on these responses?

hypovolemic shock

What are some treatments for peripheral venous disorders?

insertion of a greenfield filter, vein ligation, sclerotherapy

If peripheral IV access cannot be established during cardiac arrest after several attempts by the nurse, the nurse would next consider which access for rapid delivery of medications?

intraosseous (IO) access

The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following?

myocardial injury

Which structures are included in the external genitalia of the male anatomy? Select all that apply. One, some, or all responses may be correct.

penis, scrotum

Which diagnostic tests are used to measure kidney size? Select all that apply. One, some, or all responses may be correct.

radiography, computed tomography (CT)

A client's monitor shows a PQRST wave for each beat and indicates a rate of 120 beats per minute. The rhythm is regular. Which would the nurse conclude that the client is experiencing?

sinus tachycardia

Which dietary restriction will the nurse expect to be included in the plan for a client with left ventricular failure?

sodium

Which electrolyte deficiency triggers the secretion of renin?

sodium

Which object would the nurse teach the client with a newly implanted pacemaker to avoid?

strong magnet

What can benign prostatic hyperplasia lead to?

troublesome lower urinary tract symptoms

Which surgeries are associated with permanent contraception? Select all that apply. One, some, or all responses may be correct.

vasectomy, tubal ligation

Indicate whether the following findings are manifestations of arterial (A) or venous (V) disease: -Heavy ulcer drainage -Edema of the ankles -Brown pigmentation of the legs -Dull ache in calf or thigh -Pruritus

venous disease

Which goal would the nurse expect a client receiving treatment for bacterial cystitis to achieve before their discharge from the hospital?

Achieve relief of clinical symptoms and maintain kidney function.

Which statement indicates the nurse has a correct understanding of kidney ultrasonography?

"Kidney ultrasonography makes use of sound waves and has minimal risk."

The day after receiving instructions regarding dressing changes and care of a recently inserted nephrostomy tube, the client states, "I hope I can handle all this at home; it's a lot to remember." Which response would the nurse use?

"You seem to be nervous about going home."

What is pyelonephritis?

A bacterial infection of the kidneys

How long will a client's ovum stay viable for fertilization after its release?

72 hours

Which statement is accurate regarding erythropoietin?

An erythropoietin deficiency is associated with renal failure (erythropoietin is produced in the kidneys)

During auscultation of the heart, where would the nurse expect the first heart sound (S1) to be the loudest?

Apex of the heart

The nurse is assessing the needs of a client who just learned that a tumor is malignant and has metastasized to several organs and that the illness is terminal. Which behavior would the nurse expect the client to exhibit during the initial stage of grieving?

Asking for a second opinion

Which electrical activity of the cardiac conduction system is reflected in the P wave?

Atrial depolarization

Indicate whether the following manifestations are characteristic of Buerger's disease or Raynaud's Phenomenon? -inflammation of midsized arteries and veins -strongly associated with smoking -amputation of digits or legs below the knee may be done due to ulceration and gangrene -intermittent claudification of feet, arms, and hands may be present -treated with Plavix and Trental

Buerger's disease

When a client is admitted to the postanesthesia care unit after surgery, how frequently will the nurse plan to assess the blood pressure?

Every 10 to 15 minutes

Before a client with syphilis can be treated, which issue must be addressed?

Existence of allergies

What would the presence of ketones in the urine of a client indicate?

Fat metabolism

A client, transferred to the postanesthesia care unit after a transurethral resection of the prostate (TURP), has an intravenous (IV) line and a urinary retention catheter. During the immediate postoperative period, for which potentially critical complication would the nurse monitor?

Hemorrhage

The nurse is educating a couple concerning the process of fertilization. Which hormone would the nurse explain as stimulating the release of estrogen and progesterone after fertilization?

Human chorionic gonadotropin (hCG)

The nurse shares the discharge instructions with a client who has prostate cancer. The client asks, "How much more blood will they need? Don't they have enough?" Which laboratory test would the nurse discuss the need to monitor throughout the course of the disease?

Prostate-specific antigen (PSA) (Explanation: The PSA is an indication of the presence of prostate cancer; the higher the level, the greater the tumor burden)

Which part of the nephron secretes creatinine for elimination?

Proximal tubule

Which statement explains why women have a greater risk for recurrent urinary tract infections than men do?

Proximity of the urethra to the anus

The nurse is assessing an electrocardiogram (ECG) rhythm strip. Which component of the tracing will the nurse observe to determine ventricular depolarization?

QRS Complex

Indicate whether the following manifestations are characteristic of Buerger's disease or Raynaud's Phenomenon? -involves cutaneous arteries of the fingers and toes -treated with calcium-channel blockers (esp. Procardia) -predominant in young females -episodes involve white, blue, and red color changes of the fingertips -precipitated by exposure to cold, caffeine, tobacco -frequently associated with autoimmune disorders

Raynaud's Phenomenon

Which action is promoted by vasopressin?

Reabsorption of water (Explanation: also known as an antidiuretic hormone. It helps in the reabsorption of water into the capillaries)

To ensure accuracy when assessing a client's blood pressure, how would the nurse prevent a parallax error?

Read the manometer at eye level

The nurse is performing a male reproductive system assessment of an older adult client. The nurse expects which age-related finding?

Reduced size of testes

Which process is a function of the kidney hormones?

Renin raises blood pressure because of angiotensin and aldosterone secretion

When caring for a client with an infection caused by group A beta-hemolytic streptococci, the nurse will monitor for which complication?

Rheumatic fever

Which glands help in lubricating the female urinary meatus?

Skene glands

A client recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary health care provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests would the nurse expect the primary health care provider to prescribe to confirm this diagnosis?

Urinalysis with a urine culture and sensitivity

A client has an open reduction and internal fixation (ORIF) of a fractured hip. The nurse monitors this client for signs and symptoms of a fat embolism. Which client assessment finding reflects this complication?

Tachycardia and petechiae over the chest (Explanation: Tachycardia occurs because of an impaired gas exchange; petechiae are caused by occlusion of small vessels within the skin)

Which statement reflects the nurse's suspicions regarding a client's cloudy urine noted on a urinalysis report?

The client has a urinary infection.

Which information would the nurse include when teaching about why women are more susceptible to urinary tract infections than men?

The length of the urethra (Explanation: The length of the urethra is shorter in women than in men; therefore microorganisms have a shorter distance to travel to reach the bladder)

Which instruction would the nurse provide a client needing to collect a clean-catch urine specimen?

Urinate a small amount, stop flow, and then fill one half of the specimen cup

To help prevent a cycle of recurring urinary tract infections in a female client, which instruction would the nurse share?

Urinate as soon as possible after intercourse

Which intervention is the best approach to condom use for prevention of sexually transmitted infection?

Use of a condom with oral sex

Before client examination, the registered nurse provides education for a student nurse regarding the gross anatomy and physiology of the kidneys. Which statement made by the student nurse indicates the need for additional teaching?

The right kidney is a little longer and narrower than the left kidney. (Explanation: Generally in a human body, the left-side kidney is slightly longer and narrower compared with the right-side kidney)

A client with chronic kidney disease selects treatment using continuous ambulatory peritoneal dialysis (CAPD). Which statement indicates the client understands the purpose of this therapy?

The treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion.

A client with type 1 diabetes asks what causes several brown spots on the skin. What would be the best response by the nurse?

Those brown spots result from small blood vessel damage; the blood contains iron, which leaves a brown spot.

Which physiological process causes temperature elevation after a client has had a myocardial infarction?

Tissue necrosis and inflammation

The nurse prepares a male client with a history of recurrent urinary tract infections (UTIs) for discharge after a ureterolithotomy. Which clinical manifestations of a UTI would the nurse teach this client to recognize?

Urgency or frequency of urination

Which modifiable risk factor would the nurse include in a community presentation on cardiovascular risk factors? Select all that apply. One, some, or all responses may be correct.

weight, inactivity, cholesterol, tobacco use, homocysteine